Author + information
- Received September 23, 2019
- Revision received November 27, 2019
- Accepted December 10, 2019
- Published online February 24, 2020.
- Yao Lu, MD, PhDa,b,∗,
- Raimund Pechlaner, MD, PhDc,∗,
- Jingjing Cai, MD, PhDd,∗,
- Hong Yuan, MD, PhDa,d,e,
- Zhijun Huang, MDa,
- Guoping Yang, MD, PhDa,
- Jiangang Wang, MD, PhDe,
- Zhiheng Chen, MSe,
- Stefan Kiechl, MDc,f,∗ (, )@imed_tweets and
- Qingbo Xu, MD, PhDg,h,∗∗ ()
- aCenter of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
- bDepartment of Life Science and Medicine, King’s College London, London, United Kingdom
- cDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- dDepartment of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
- eHealth Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- fVASCage, Research Centre for Promoting Vascular Health in the Ageing Community, Innsbruck, Austria
- gSchool of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
- hDepartment of Cardiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China
Background Arterial stiffening is central in the vascular aging process. Traditionally, vascular research has focused on atherosclerotic vascular disease, whereas arterial stiffness has not attracted similar attention.
ObjectiveS The purpose of this study was to assess lifetime trajectories of arterial stiffening in Chinese populations facing a high burden of cardiovascular disease, with a particular focus on age–sex interactions and potential determinants.
Methods This large-scale observational study comprised 2 independent cross-sectional population samples and 1 prospective cohort totaling 80,415 healthy subjects with brachial-ankle pulse wave velocity (baPWV) measurements available. Associations with potential risk conditions were analyzed using linear regression, linear random intercepts mixed models, and L1-regularized linear models.
Results The dynamics of age-dependent arterial stiffening differed in sexes, with stiffer vessel observed in men from adolescence to age 58 years and in women thereafter. The steeper increase in baPWV in women after menopause is partly explained by the fact that vascular risk factors are more strongly associated with arterial stiffness in women than in men. Age and systolic blood pressures were the strongest determinants of baPWV, whereas other vascular and metabolic risk factors, except low-density lipoprotein cholesterol, showed consistent associations of moderate strength.
Conclusions The significant age–sex interaction in arterial stiffening provides an important clue of explanation for the heightened cardiovascular disease risk in postmenopausal women. Detailed knowledge on lifetime trajectories of arterial stiffening, and its potential risk factors is a prerequisite for the development of new prevention strategies counteracting vascular aging.
↵∗ Drs. Lu, Pechlaner, and Cai contributed equally to this work.
This study was supported by the excellence initiative VASCage (Centre for Promoting Vascular Health in the Ageing Community, project number 868624) of the Austrian Research Promotion Agency FFG (COMET program–Competence Centers for Excellent Technologies) funded by the Austrian Ministry for Transport, Innovation and Technology; the Austrian Ministry for Digital and Economic Affairs; and the federal states Tyrol (via Standortagentur), Salzburg, and Vienna (via Vienna Business Agency); as well as by the National Science Foundation of China (81800393, 81870171, and 81570271) and the Science and Technology Planning Project of Hunan Province (2019RS2014). Dr. Kiechl is CSO of VASCage, a competence center of the Austrian Research Promotion Agency, with 50 university and company partners. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 23, 2019.
- Revision received November 27, 2019.
- Accepted December 10, 2019.
- 2020 American College of Cardiology Foundation
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